Individual
MANKAZON TIDOE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Contact information
Practice address
14 GALWAY PL, TEANECK, NJ 07666-3631
(201) 837-9273
Mailing address
14 GALWAY PL, TEANECK, NJ 07666-3631
(201) 837-9273
Taxonomy
Speciality
Code
Description
License number
State
164W00000X
Licensed Practical Nurse
Primary
311887-1
NY
Other
Enumeration date
11/27/2012
Last updated
11/27/2012
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